重症监护病房脓毒症患者微生物培养特点及相关因素分析

发布时间：2018-04-25 04:04

  本文选题：脓毒症 + 微生物培养　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的:了解重症监护病房脓毒症患者微生物培养分离出的致病菌特点及探讨影响微生物培养结果的相关因素。方法:采用回顾性分析方法,对2012年6月-2016年12月广西医科大学第一附属医院重症监护病房188例脓毒症患者的一般情况、临床和入住重症病房24小时内实验室检查结果等资料的收集,了解本院重症监护病房脓毒症患者微生物培养特点,通过对微生物培养阳性患者和阴性患者的一般情况、炎症指标、危重评分、预后及抗生素使用情况进行分析,探讨影响脓毒症患者微生物培养结果的相关因素。结果:(1)微生物培养分离出病原菌112株,G-细菌48株(42.8%);真菌39株(34.8%);其中G+细菌13株(11.6%);混合感染12株(10.7%)。血培养分离出致病菌28株,阳性率14.9%。(2)年龄、白细胞、中性粒细胞比值在微生物培养阳性与阴性患者组间无统计学差异,微生物培养结果与PCT浓度、APACHE Ⅱ评分、SOFA评分、预后相关,均成正相关,微生物培养阳性组患者在PCT浓度、APACHE Ⅱ评分、SOFA评分、病死率均比阴性组高。(3)PCT浓度对微生物培养结果影响有统计学意义,PCT参照水准为PCT≥10ng/ml时,在PCT0.5ng/ml微生物培养结果出现阴性的可能性是PCT≥10.0ng/ml的4.844倍。(4)PCT浓度、APACHE Ⅱ评分、SOFA评分预测微生物培养结果(阴性或阳性)的ROC曲线下面积分别为0.628、0.632、0.618。结论:(1)本研究中重症监护病房脓毒症患者微生物培养的致病菌最主要的是G-细菌,其次为真菌,然后是混合感染和G+细菌。(2)微生物培养结果与病情危重程度、PCT浓度呈正相关,脓毒症患者病情越重、PCT浓度越高,微生物培养阳性率越高。
[Abstract]:Objective: to investigate the characteristics of pathogenic bacteria isolated from sepsis patients in intensive care unit (ICU) and the related factors affecting the results of microbial culture. Methods: the general situation of 188 sepsis patients in intensive care unit of the first affiliated Hospital of Guangxi Medical University from June 2012 to December 2016 was analyzed retrospectively. To collect the results of clinical and laboratory examination in intensive care unit within 24 hours, to understand the characteristics of microbial culture in sepsis patients in intensive care unit, and to investigate the general situation of positive and negative patients with microorganism culture. The inflammatory index, critical score, prognosis and antibiotic use were analyzed to explore the related factors affecting microbial culture results in sepsis patients. Results 112 strains of pathogenic bacteria were isolated from microorganism culture, 48 strains of G- bacteria were isolated, 39 strains of fungi were found to be 34. 8%, 13 strains of G bacteria were found to be 11. 6% and 12 strains of mixed infection were 10. 7% and 10. 7% respectively. 28 strains of pathogenic bacteria were isolated from blood culture, the positive rate was 14.9%. The age, the ratio of leukocytes and neutrophils were not significantly different between the positive and negative groups. The results of microbial culture were correlated with the PCT concentration and Apache 鈪，

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